Organization
EDGEWATER FAMILY DENTISTRY PLLC
Active
Other names
Edgewater Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN TOMALTY DMD (OWNER)
(561) 633-9676
Entity
Organization
Contact information
Practice address
3512 DEL PRADO BLVD S STE 102, CAPE CORAL, FL 33904-7261
(239) 540-1033
Mailing address
3512 DEL PRADO BLVD S STE 102, CAPE CORAL, FL 33904-7261
(239) 540-1033
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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